Angela Fagan

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R858439 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-6426

Fax

(601) 984-5503

NPI assigned

Dec 3, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

State of Mississippi - University of Mississippi Medical CenterGroup PAC ID 1850293036, 956 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001
• Mississippi Methodist Rehab Ctr Hospital, Jackson, MS, CCN 250152

Merit-based Incentive Payment System (MIPS)

Final score

83.94 of 100Reported as group

Quality

67.75

Promoting interoperability

100

Improvement activities

40

Cost

71.17

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: afagan25287@ummc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment Care Compare group NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• University Physicians, PLLC

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1609984574
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Tupelo, MS
  • NPI 1205604071

  Hospital

  Care Compare affiliation
• Mississippi Methodist Hospital & Rehabilitation Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1841349792
  Care Compare affiliation
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1073944971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5500",
            "fax_number": "601-984-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6426",
            "fax_number": "601-984-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R858439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04888572",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Elaine Ezell, NP
• Gabrielle Facey, M.D.
• Edward Alexander Facundus
• Olivia Patch Facundus
• Abigail Kathryn Fagan
• Byron W Fair, PT
• Logan D Fair, MD
• Joseph Matthew Fairley Sr.
• Faith & Hope Independent Living Health Services of Ms Inc.
• Faith and Hope Adult Daycare

• Acute Care Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Acute Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.